Why you should care

Meet the social worker who is using scientific data to improve the lives of LGBT youth.

By Lorena O'Neil

The Daily DoseJUN 28 2014

Caitlin Ryan is an LGBT family whisperer.

“When I started this work, the perception of families was that they really were the enemy,” says Ryan of her work mediating between lesbian, gay, bisexual and transgender youth and their parents. “Awareness is starting to crack open that everyone needs this information.”

Ryan is a clinical social worker whose evidence-based family intervention model has turned the world of LGBT healthcare on its head. It embraces not only disapproving families, but also cultures and faith traditions that are inhospitable to LGBT kids. Overcoming these rifts is crucial to the physical and mental health of LGBT youth, and it can be done, Ryan argues, without asking the family to disregard their religious or cultural values.

There was no more time … whatever doctrine or dogma had prevented them from accepting their child.

– Caitlin Ryan

In 2002, Ryan and colleague Rafael Diaz started a comprehensive study to evaluate the mental and physical health outcomes for children whose families either tried to “fix” their LGBT identity or who rejected them in any way. Turns out, the effect was enormous, as their results published in the Journal of Pediatrics showed: Those who are forcefully rejected by their families or caregivers are more than 8 times as likely to attempt suicide, nearly 6 times as likely to report high levels of depression and more than 3 times as likely to use illegal drugs and be at high risk for HIV and STDs.

Gay children who aren’t embraced by their parents when they come out are often counseled to cut ties, on the assumption that zero contact with critical family members is better for the child’s emotional health. But Ryan’s work suggests that emotional ties to families are so foundational that they should be included, not replaced.

“We’ve kind of had this assumption that families are part of the problem,” says Ann Haas, a senior consultant to the American Foundation for Suicide Prevention, “And [haven’t looked at] at the question of how families can be really helped and supported and educated and motivated to really play a positive role. Caitlin’s work has added that perspective.”

Source Corbis

Ryan and her team at the Family Acceptance Project (FAP), based out of San Francisco State University, developed educational materials to fill in that gap, including booklets and short films that coach families how to become less rejecting. The materials train service providers, schools and faith-based organizations in family intervention techniques that acknowledge parents’ anxieties, view them as allies and give them respectful vocabulary for talking about their child’s sexual orientation or gender identity. Ryan has trained 50,000 people in the U.S., Canada, Mexico, Spain, Latin America and China over the last 12 years.

Ryan was the eldest of four and moved from Connecticut to the Midwest to New Jersey with her Irish-Catholic family, all before the age of 11. She came out in the 1970s. “I came out in a religious family and it was a struggle for my family to understand; they had very few resources. It was a really difficult time to come out and be out.”

At age 50, Ryan decided to pursue a doctorate. As inspiration, she pinned up a photo in her office of a 93-year-old woman graduating with a doctorate.

She began studying AIDS policy around the same time, prior to and during the epidemic. “I would meet with families while they were there with their dying sons,” she recalls. “Most people saw an experience of rejection. I saw those extraordinary emotions of people that saw there was no more time with their children, that whatever doctrine or dogma or prejudice or disinformation had prevented them from accepting their child. So many of them would do anything to have more time.”

Ellen Kahn, a social worker at Human Rights Campaign says that, while many can intuit that the more accepting a family is, the better off a young person will be, Ryan’s scientific data make it all the more convincing. FAP is particularly effective with religious families, many of whom wouldn’t turn to LGBT organizations for counseling. “We’re giving them permission to love their child, even if they feel like what their child is is wrong,” says Ryan.

Ryan is steering the conversation away from homosexuality as a moral issue to a health issue.

That last statement can sound jarring, suggesting that acceptance and religious intolerance can coexist. Hardline LGBT advocates may see it as overly accommodating, since it fails to challenge a core belief in the “wrongness” of being gay. But Ryan isn’t trying to preserve that belief; she’s trying to mitigate the health damage it can cause by moving parents down the spectrum from high-level rejection toward acceptance.

Her key tactic is steering the conversation away from homosexuality as a moral issue to a health issue. A parent might be told by that “reparative therapy” will help “fix” their “sinful” child by “turning them straight” — something currently endorsed by the Texas GOP — but Ryan’s research demonstrates that “reconditioning” can severely damage a child’s mental health. With her training, Ryan strives to remove blame and judgment — by parents and of them.

“In the past it was all or nothing,” says Ryan. “Families had to choose between their child and their faith. What we are doing is changing the discourse with which homosexuality is addressed.” It does get better, but maybe that’s not enough. If we listen to Ryan, it gets even better if you can bring Mom and Dad along for the ride, regardless of their cultural or religious values.